Provider Demographics
NPI:1447494992
Name:CARROLL-HAMPSHIRE, LATONYA D (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LATONYA
Middle Name:D
Last Name:CARROLL-HAMPSHIRE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 477
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-0477
Mailing Address - Country:US
Mailing Address - Phone:620-275-0644
Mailing Address - Fax:620-272-0239
Practice Address - Street 1:506 AVENUE L
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-5319
Practice Address - Country:US
Practice Address - Phone:620-227-8566
Practice Address - Fax:620-225-5824
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS685106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist